conducting system Flashcards

cellular electrical activity: explain membrane potential and changes in ionic permeability; draw action potentials for the ventricle and sino-atrial node; explain the role of the sino-atrial node and importance of refractory periods

1
Q

what is the potassium hypothesis of membrane potential

A

K+ can move over semi-permeable cell membranes and Cl- cannot, so K+ diffuse out of the cell down their K+ gradient and reach equilibrium when positive charge outside the cells repels the efflux of K+, resulting in no net movement over the membrane

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2
Q

when is membrane potential equilibrium achieved

A

when electrical gradient exactly balances chemical gradient

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3
Q

define driving force

A

difference between electrical gradient and chemical gradient (at equilibrium, driving force is 0mV)

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4
Q

what does membrane potential depend on most

A

efflux of K+

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5
Q

what is the equation used to predict what the potential difference will be across semi-permeable membrane

A

Nernst

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6
Q

if the membrane is uniquely permeable to K+ at diastole (resting membrane potential), what is the potential difference across the membrane equal to

A

K+ equilibrium potential

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7
Q

how is [K+] in the cell restored after depolarisation

A

Na+/K+-ATPase pumps

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8
Q

what changes membrane potential in the heart, causing different action potential profiles

A

relative permeabilities of membrane to various ions (different cell types in heart express different ion currents flowing and different ion channel expression in membrane)

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9
Q

if the membrane is uniquely permable to Na+ at upstroke of action potential, what is the potential difference across the membrane equal to

A

Na+ equilibrium potential

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10
Q

why is Goldman-Hodgkin-Katz equation used

A

takes into account relative permeabilities of several ions simultaneously

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11
Q

diagram to show change in membrane potential over time

A

benjis

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12
Q

what happens in phase 0 (upstroke)

A

reaches threshold potential so hugely increased permeability to Na+ due to open channels so Na+ influx; more dependent on Na+ influx than Ca2+ influx; membrane potential depolarised from -70mV to +40mV

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13
Q

what happens in phase 1 (early repolarisation)

A

transient outward current due to brief K+ efflux

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14
Q

what do phases 1 and 2 occur simultaneously with and what channel does it enter through

A

Ca2+ influx through L-type channels

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15
Q

what does Ca2+ influx promote

A

release of further internal Ca2+ (binds to SR Ca2+ release channel), prolonging action potential

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16
Q

what does Ca2+ trigger

A

contraction

17
Q

what happens in phase 2 (plateau)

A

K+ efflux is electrically balanced with Ca2+ influx due to gradual activation of K+ currents

18
Q

what happens in phase 3 (repolarisation)

A

K+ permeability slowly increases to partially repolarise, and when potential becomes low enough (overcome influx of Ca2+, and the Ca2+ channels slowly close (Ca2+ ATPase starts to pump Ca2+ back into SR), IK1 opens significantly to efflux large amount of K+, returning cell to resting membrane potential

19
Q

what happens in phase 4 (resting membrane potential)

A

IK1 open to allow flow during diastole, stabilising resting membrane potential

20
Q

ventricle and SAN action potential differences

A

SAN keeps oscilating, SAN has no IK1 current so no resting membrane potential, Na+ channels open in SAN diastole to produce small dissociation, but upstroke provided by Ca2+ influx

21
Q

what Ca2+ channels are activated in SAN

22
Q

what is the significance of T-type Ca2+ channels being present in the SAN

A

activate at more negative potentials than L-type, so require smaller depolarisation

23
Q

how is repolarisation brought about in the SAN

A

inactivation of Ca2+ channels so reduced Ca2+ influx

24
Q

where is the SAN located

A

below epicardial surface at right atria/superior vena cava boundary

25
structure of SAN
group of specialised cells
26
role of SAN
spontaneously depolarise to allow autorhythmic contraction, starting conduction pathway, by nerves synapsing to it
27
which nervous system is the extrinic nerve supply of the heart
autonomic nervous system
28
what does the autonomic nervous system do to the heart
modulate pacemaker activity and control intrinsic beating established by heart
29
what nervous systems control heart rate and what neurotransmitters do each secrete
sympathetic (noradrenaline) and parasympathetic (acetylcholine) nervous system, which synapse with SAN cells
30
effect on heart rate and contractility of increasing sympathetic stimulation
membrane depolarises and reaches threshold potential more quickly, increasing heart rate (positive chronotropy) and contracilitiy (positive inotropy)
31
effect on heart rate of increasing parasympathetic stimulation
membrane depolarises and reaches threshold potential more slowly, decreasing heart rate
32
what nerves modulate intrinsic heart rate
vagus nerve (parasympathetic nerve), accelerans nerve (sympathetic nerve)
33
where are the cardioregulatory and vasomotor centres from where the vagus nerve begins
medulla
34
what is the duration of cardiac action potential and purpose
200-300ms (very long), allowing it to be an effective pump
35
define absolute refractory period
time during which no action potential can be inititated regardless of stimulus intensity
36
define relative refractory period
period after absolute refractory period where an action potential can be elicited, but only with stimulus strength larger than normal (leading to reduced risk of arrhythmias in specialised IK1)
37
what are refractory periods caused by
Na+ channel inactivation
38
when do Na+ channels recover from inactivation
during membrane repolarisation (more negative membrane potential = more channels reactivated to allow heart filling)
39
why don't tetanic (summation) contractions occur in cardiac muscle
long refractory period so not possible to re-excite muscle until process of contraction well underway